In case of ligation of the infundibulopelvic ligament with haematoma ,can the ovary survive or is adnexectomy needed? What about future fertility after ligation without adnexectomy?
About 50% ovaries get their entire blood supply through ovarian artery. Those ovaries may perish! The rest which get blood through uterine artery will be OK. But such hematomas will not be bilateral & so unilateral ligation will keep the opposite ovary intact!
Thank you for the answer. is it better to excise this adenxa with hematoma or leave it for follow up? what about the reference for the above data? ehat about bilateral hematoma management?
I'll share the reference with you. Hematoma can be left alone after draining, if the patient is stable. A follow-up scan is in order. Same is true with bilateral hematoma.
I agree with Dr. Parul Kotdawala that blood supply to the ovary is mostly from ovarian artery.
This figure gives an idea about blood supply to ovaries. 56% get it from both - ovarian and the uterine. 40% only from ovarian & 4 % only from uterine. The implications are clear. Ligating the uterine on both sides can also lead to premature ovarian failure!
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